Drug IndexRuxience (rituximab-pvvr)



Billing

Code: Q5119

Description: Inj ruxience, 10 mg

Unit: 10 MG

Payment: $20.275

Pay quarter: Q2 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$7,168.00

Total Reimbursement:

$2,027.50

(ASP: $1,912.74, Margin: $114.76)

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# Units to bill:

100

Dosage & Frequency

Rheumatoid Arthritis (RA)

• Two 1000mg IV doses separated by 2 weeks, every 6 months


Billable NDCs

00069-0238-01

Ruxience (PFIZER INC.)

100 MG


00069-0249-01

Ruxience (PFIZER INC.)

500 MG



Prior Authorization

Aetna

United Healthcare

Anthem

Cigna


Resources

Website

Drug Enrollment Form